A prospective, randomized controlled trial of circumcision in adult males using the CO2 laser: modified technique compared with the conventional dorsal-slit technique.

Objective: The purpose of this study was to investigate the safety and efficacy of a modified CO2 laser technique for circumcision in adult males as compared with the conventional dorsal-slit method.

Background Data: Circumcision is one of the most commonly performed surgeries in the world. Although present techniques produce a good long-term result, there is a continuing need to improve the safety and efficacy of the circumcision procedure.

Materials And Methods: Data were analyzed from a prospective randomized controlled clinical study comparing two different operative techniques for adult circumcision: the modified CO2 laser circumcision technique, and the conventional dorsal-slit technique. A total of 300 patients >18 years of age were recruited in this study. Several perioperative data, including age, indications, operation time, intraoperative blood loss, complications, and postoperative pain were analyzed. Differences between the CO2 laser technique and the conventional technique were compared.

Results: There was no statistically significant difference in age distribution and indications between the two groups. Compared with the conventional group, there were shorter operative time, less blood loss and lower postoperative complication rate in the laser group. The CO2 laser technique was associated with much less pain, as quantitated by a 10 point visual analogue scale (VAS) pain score at both 1 day and 7 days postoperatively.

Conclusions: The modified CO2 laser technique that we introduced offers a simple, safe, faster, and effective alternative method to the conventional technique in adult male circumcision, with decreased blood loss, pain, and complications.